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K
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s
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Ad
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An
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J
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Me
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CC B
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C
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Dep
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Facu
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T
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Dr
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Had
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So
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Po
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Po
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C
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W
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I
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RO
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Dep
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an
x
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d
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C
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-
1
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p
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p
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ly
f
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an
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Asi
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an
d
later
d
ec
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d
af
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th
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p
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d
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[
1
]
.
R
ep
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ted
r
ates
r
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(
2
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f
o
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Feb
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a
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d
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ly
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[
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m
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1
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[
3
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.
I
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S.,
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with
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p
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p
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with
lo
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co
n
o
m
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tatu
s
[
4
]
.
A
s
y
s
tem
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li
ter
atu
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r
ev
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w
also
s
h
o
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is
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g
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an
x
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p
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ce
af
ter
SAR
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C
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2
in
f
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tio
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r
an
g
in
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f
r
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m
(
1
6
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6
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t
o
(
2
9
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ac
r
o
s
s
d
if
f
er
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n
t
q
u
esti
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n
n
air
es
[
5
]
.
I
n
So
u
th
ea
s
t
Asi
a,
a
h
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f
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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I
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b
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Hea
lth
Sci
,
Vo
l.
15
,
No
.
1
,
M
ar
ch
20
26
:
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7
1
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78
172
p
s
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ch
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lo
g
ical
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is
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ticu
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aOR
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[
1
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–
1
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1
5
]
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,
wh
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d
s
tr
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less
co
m
m
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[
6
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.
Natio
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th
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2
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2
I
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d
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esia
Natio
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Ad
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lescen
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Hea
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I
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NAM
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ted
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t f
r
eq
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e
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t
[
7
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.
Stre
s
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f
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th
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p
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as
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[
9
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.
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y
–
A
m
in
o
b
u
t
y
r
ic
a
cid
(
GABA)
)
,
r
esu
ltin
g
in
d
ef
icits
in
m
em
o
r
y
,
lear
n
in
g
,
an
d
b
e
h
av
io
r
,
as
well
as
em
o
tio
n
al
an
d
p
s
y
ch
o
lo
g
ical
p
r
o
b
lem
s
[
1
0
]
.
Pro
in
f
lam
m
ato
r
y
cy
to
k
in
es
(
I
L
-
6
)
ar
e
h
y
p
o
th
esized
to
im
p
ac
t
th
e
p
ath
way
s
o
f
ir
o
n
m
etab
o
lis
m
u
n
d
er
ch
r
o
n
ic
s
tr
ess
co
n
d
it
io
n
s
,
d
y
s
r
e
g
u
lated
c
o
r
tis
o
l
,
ep
ig
en
etic
c
h
an
g
es,
in
cr
ea
s
ed
cy
to
k
in
e
s
,
an
d
p
r
o
in
f
lam
m
atio
n
.
P
ro
in
f
lam
m
atio
n
r
esu
lts
in
a
ch
a
n
g
e
in
h
ep
cid
in
ac
tiv
ity
d
u
r
in
g
th
e
i
n
f
lam
m
atio
n
p
e
r
io
d
,
an
d
ev
en
t
u
ally
in
cr
ea
s
e
s
th
e
r
is
k
o
f
ir
o
n
d
ef
icien
c
y
ass
o
ciate
d
with
ch
r
o
n
ic
s
tr
ess
[
1
1
]
.
C
o
n
v
er
s
ely
,
it
is
r
ep
o
r
ted
t
h
at
ir
o
n
d
ef
icien
cy
wo
u
ld
in
cr
ea
s
e
th
e
r
is
k
o
f
an
x
iety
d
is
o
r
d
er
s
[
1
2
]
,
[
1
3
]
,
d
ep
r
e
s
s
io
n
[
1
3
]
–
[
1
5
]
,
an
d
s
tr
ess
[
1
1
]
.
A
s
tu
d
y
in
SMPN
1
7
T
a
n
g
er
a
n
g
in
2
0
2
2
f
o
u
n
d
th
at
f
em
ale
ad
o
lescen
ts
s
u
f
f
er
ed
f
r
o
m
a
n
e
m
ia
(
4
0
%).
So
m
e
o
f
t
h
e
ca
u
s
es
o
f
an
em
ia
ar
e
in
ad
e
q
u
ate
k
n
o
wled
g
e
,
lo
w
m
ater
n
al
ed
u
ca
tio
n
,
f
am
ily
in
co
m
e,
a
n
d
ea
tin
g
h
ab
its
[
1
6
]
.
T
h
e
lo
w
co
n
s
u
m
p
tio
n
o
f
p
r
o
tein
(
p
:
0
.
3
7
8
)
an
d
ir
o
n
(
p
:
0
.
0
8
7
)
was
id
en
tifie
d
as
a
r
is
k
f
ac
to
r
o
f
an
em
ia
,
esp
ec
ially
a
m
o
n
g
f
e
m
ale
ad
o
lescen
ts
[
1
7
]
.
Dietar
y
p
atter
n
s
in
v
o
lv
in
g
p
r
o
tein
an
d
ca
r
b
o
h
y
d
r
ate
in
tak
e,
as
well
as
th
e
n
u
tr
itio
n
al
s
tatu
s
,
h
ad
a
r
elatio
n
s
h
i
p
with
an
em
ia
ca
s
es
,
an
d
m
aln
u
tr
itio
n
s
tatu
s
wo
u
ld
in
cr
ea
s
e
th
e
r
is
k
o
f
a
n
em
ia
a
m
o
n
g
a
d
o
lescen
ts
b
y
5
.
3
5
ti
m
es
[
1
8
]
.
B
esid
es,
s
tr
ess
wo
u
ld
ch
an
g
e
s
o
m
e
o
n
e'
s
ea
tin
g
h
ab
its
;
th
e
k
in
d
s
o
f
f
o
o
d
th
ey
ch
o
o
s
e
wo
u
ld
b
e
h
i
g
h
i
n
f
at
an
d
s
u
g
ar
,
a
n
d
lo
w
in
ir
o
n
[
1
1
]
.
Nu
tr
itio
n
al
s
tatu
s
b
ased
o
n
th
e
m
ea
s
u
r
em
en
t
o
f
u
p
p
e
r
ar
m
cir
cu
m
f
er
en
ce
also
h
ad
a
s
ig
n
if
ican
t
r
elatio
n
s
h
ip
with
an
em
ia
am
o
n
g
f
em
ales
[
1
9
]
.
B
ased
o
n
a
s
tu
d
y
c
o
n
d
u
cted
in
s
en
i
o
r
h
ig
h
s
ch
o
o
ls
in
Po
n
tian
ak
i
n
2
0
2
3
,
th
e
r
e
wer
e
m
o
r
e
ad
o
lescen
ts
with
u
n
d
er
weig
h
t
n
u
tr
itio
n
al
s
tatu
s
th
an
th
o
s
e
with
o
v
er
weig
h
t
(
2
9
.
9
%
:
2
1
.
4
%).
T
h
is
co
n
d
itio
n
co
u
ld
lead
to
an
em
ia
am
o
n
g
ad
o
lescen
ts
,
ev
en
th
o
u
g
h
s
o
m
e
s
tu
d
ies
s
h
o
wed
th
at
th
er
e
was
n
o
r
elatio
n
s
h
ip
b
etwe
en
n
u
tr
itio
n
al
s
tatu
s
an
d
an
em
ia
ca
s
e
s
[
2
0
]
,
[
2
1
]
.
C
o
n
s
u
m
p
tio
n
o
f
ir
o
n
s
u
p
p
lem
e
n
t
s
b
y
ad
o
lescen
ts
is
also
im
p
o
r
ta
n
t
n
o
t
o
n
ly
to
p
r
e
v
en
t
a
n
em
ia
b
u
t
also
to
s
ig
n
if
ican
tly
d
ec
r
ea
s
e
p
s
y
ch
iatr
ic
p
r
o
b
lem
s
o
f
p
atien
ts
with
ir
o
n
-
d
e
f
icien
cy
an
e
m
ia
[
1
0
]
.
T
h
is
s
tu
d
y
is
ex
p
ec
ted
t
o
s
er
v
e
as
a
b
asis
f
o
r
im
p
r
o
v
in
g
th
e
r
eg
u
latio
n
a
n
d
d
is
tr
ib
u
tio
n
o
f
i
r
o
n
s
u
p
p
lem
en
tatio
n
f
o
r
ad
o
lescen
ts
,
a
p
r
o
g
r
am
cu
r
r
en
tly
tar
g
eted
at
th
o
s
e
ag
ed
1
2
-
1
8
y
ea
r
s
.
At
p
r
esen
t,
th
e
im
p
lem
en
tatio
n
is
m
o
r
e
co
n
ce
n
tr
ated
in
s
en
io
r
h
i
g
h
s
ch
o
o
ls
,
an
d
co
v
er
ag
e
am
o
n
g
ju
n
io
r
h
ig
h
s
ch
o
o
l
s
tu
d
e
n
ts
r
em
ain
s
lim
ited
.
E
ar
ly
ad
o
les
ce
n
ts
,
h
o
wev
er
,
ar
e
also
v
u
ln
er
ab
le
to
ir
o
n
d
e
f
icien
cy
d
u
e
to
r
ap
id
g
r
o
wth
an
d
in
cr
ea
s
ed
p
h
y
s
io
lo
g
ical
d
em
a
n
d
s
.
Fo
r
th
is
r
ea
s
o
n
,
t
h
e
r
esear
ch
er
co
n
d
u
cted
t
h
is
s
tu
d
y
to
f
o
cu
s
s
p
ec
if
ically
o
n
th
e
co
n
d
itio
n
o
f
ju
n
io
r
h
i
g
h
s
ch
o
o
l
s
tu
d
en
ts
in
Po
n
tian
ak
,
p
r
o
v
id
in
g
u
p
d
ated
d
ata
th
at
ca
n
s
u
p
p
o
r
t
th
e
n
ee
d
to
ex
p
an
d
ir
o
n
s
u
p
p
lem
en
tatio
n
an
d
p
r
e
v
en
tiv
e
s
tr
ateg
ies to
y
o
u
n
g
er
a
d
o
lescen
t g
r
o
u
p
s
.
2.
M
E
T
H
O
D
T
h
is
s
tu
d
y
u
s
ed
a
cr
o
s
s
-
s
ec
ti
o
n
al
d
esig
n
to
ass
ess
an
em
ia
s
tatu
s
,
m
en
tal
h
ea
lth
co
n
d
itio
n
s
,
an
d
n
u
tr
itio
n
al
s
tatu
s
am
o
n
g
ju
n
io
r
h
ig
h
s
ch
o
o
l
s
tu
d
en
ts
at
a
s
i
n
g
le
p
o
in
t
in
tim
e.
A
cr
o
s
s
-
s
ec
tio
n
al
d
esig
n
was
ch
o
s
en
b
ec
au
s
e
it
allo
ws
r
ese
ar
ch
er
s
to
m
ea
s
u
r
e
m
u
ltip
le
h
ea
lth
in
d
icato
r
s
s
im
u
ltan
eo
u
s
ly
an
d
ex
am
in
e
th
eir
ass
o
ciatio
n
s
ef
f
icien
tly
.
T
h
is
s
tu
d
y
was
co
n
d
u
cted
f
r
o
m
M
ay
to
Dec
em
b
er
2
0
2
4
an
d
i
n
v
o
lv
ed
2
7
7
eig
h
th
-
g
r
ad
e
s
tu
d
e
n
ts
f
r
o
m
f
iv
e
ju
n
i
o
r
h
ig
h
s
ch
o
o
ls
in
Po
n
tian
a
k
C
ity
,
W
est
Kalim
an
tan
,
I
n
d
o
n
esia
.
T
h
e
s
elec
ted
s
ch
o
o
ls
wer
e
th
o
s
e
with
th
e
lar
g
est
s
tu
d
en
t
p
o
p
u
latio
n
s
in
ea
ch
s
u
b
-
d
is
tr
ict.
T
h
e
in
itial
s
am
p
le
s
ize
was
d
eter
m
in
ed
u
s
in
g
Slo
v
in
’
s
f
o
r
m
u
la
b
ased
o
n
a
to
tal
s
tu
d
e
n
t p
o
p
u
latio
n
o
f
4
,
7
6
7
ac
r
o
s
s
th
e
f
iv
e
s
ch
o
o
ls
,
with
a
5
%
m
ar
g
in
o
f
er
r
o
r
,
r
esu
ltin
g
in
a
r
e
q
u
ir
ed
s
am
p
le
o
f
3
6
9
s
tu
d
en
ts
.
H
o
wev
er
,
d
u
r
in
g
d
ata
co
llectio
n
,
9
2
(
2
4
.
9
%)
p
a
r
en
ts
an
d
s
tu
d
en
ts
d
ec
lin
ed
th
e
b
lo
o
d
ex
am
in
at
io
n
at
th
e
in
f
o
r
m
e
d
co
n
s
en
t
s
tag
e,
r
ed
u
cin
g
th
e
f
in
al
s
am
p
le
to
2
7
7
p
a
r
ticip
an
ts
.
Sam
p
lin
g
f
o
llo
wed
a
q
u
o
ta
ap
p
r
o
ac
h
to
e
n
s
u
r
e
r
e
p
r
esen
t
atio
n
f
r
o
m
all
s
u
b
-
d
is
tr
icts
,
an
d
p
ar
ticip
an
ts
wer
e
r
ec
r
u
ited
b
ased
o
n
class
le
v
el
an
d
v
o
lu
n
ta
r
y
p
ar
ticip
atio
n
.
I
n
ad
d
itio
n
,
th
e
p
ar
en
ts
o
r
leg
al
g
u
ar
d
ian
s
o
f
p
ar
ticip
an
ts
also
p
r
o
v
id
e
in
f
o
r
m
ed
co
n
s
en
t.
Data
co
llectio
n
was
ca
r
r
ied
o
u
t
in
ea
ch
s
ch
o
o
l
f
r
o
m
2
A
u
g
u
s
t
to
3
Sep
tem
b
er
,
ac
co
r
d
in
g
t
o
th
e
s
ch
ed
u
le
ag
r
ee
d
u
p
o
n
with
s
ch
o
o
l
ad
m
in
is
tr
ato
r
s
.
Q
u
e
s
tio
n
n
air
e
d
ata
wer
e
o
b
tain
ed
th
r
o
u
g
h
g
u
id
ed
in
ter
v
iews,
co
n
d
u
cte
d
in
g
r
o
u
p
s
,
wh
er
e
th
e
r
esear
ch
e
r
d
ir
e
ctly
f
ac
ilit
ated
s
tu
d
en
ts
in
co
m
p
letin
g
th
e
p
a
p
er
-
b
ased
q
u
esti
o
n
n
air
es.
T
h
e
v
ar
iab
les
o
f
d
ep
r
ess
io
n
,
s
tr
ess
,
an
d
an
x
iety
wer
e
ass
ess
ed
u
s
in
g
a
q
u
esti
o
n
n
air
e
o
f
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
A
s
s
o
cia
tio
n
b
etw
ee
n
a
n
emia
,
men
ta
l h
ea
lth
,
a
n
d
n
u
tr
itio
n
a
l
… (
A
g
u
s
tin
a
A
r
u
n
d
in
a
Tr
ih
a
r
j
a
Tejo
yu
w
o
n
o
)
173
th
e
I
n
d
o
n
esia
-
Dep
r
ess
io
n
An
x
iety
Stre
s
s
Scale
f
o
r
Yo
u
th
(
D
ASS
-
Y
[
2
2
]
)
,
wh
ich
h
as
b
ee
n
r
ep
o
r
ted
in
an
o
t
h
er
s
tu
d
y
to
b
e
v
alid
an
d
r
eliab
le
[
2
3
]
.
I
t
is
co
m
p
r
is
ed
o
f
2
1
q
u
esti
o
n
s
th
at
ass
e
s
s
s
tu
d
en
ts
’
f
ee
lin
g
s
d
u
r
in
g
th
e
week
o
f
th
e
d
ata
co
llectio
n
.
E
ac
h
p
ar
t
o
f
th
e
DASS
-
Y
q
u
esti
o
n
n
air
e
c
o
n
tain
s
7
q
u
e
s
tio
n
s
f
o
r
ass
ess
in
g
d
ep
r
ess
io
n
,
wh
ich
ar
e
d
y
s
p
h
o
r
ia,
h
o
p
eless
n
ess
,
d
ev
alu
atio
n
o
f
life
,
s
elf
d
ep
r
ec
atio
n
,
lack
o
f
in
ter
est/
in
v
o
lv
em
en
t,
an
h
ed
o
n
ia
an
d
in
er
tia
;
item
3
,
5
,
1
0
,
1
3
,
1
6
,
1
7
,
2
1
)
,
an
x
iety
(
au
to
n
o
m
ic
ar
o
u
s
al,
s
k
eleta
l
m
u
s
cle
ef
f
ec
ts
,
s
itu
ati
o
n
al
an
x
iety
,
an
d
s
u
b
jectiv
e
ex
p
er
ien
ce
o
f
a
n
x
io
u
s
ef
f
ec
t
;
item
2
,
4
,
7
,
9
,
1
5
,
1
9
,
2
0
)
,
a
n
d
s
tr
ess
(
ch
r
o
n
i
c
n
o
n
s
p
ec
if
ic
ar
o
u
s
al,
d
if
f
i
cu
lty
r
elax
i
n
g
,
n
er
v
o
u
s
ar
o
u
s
al,
b
ein
g
ea
s
ily
u
p
s
et/ag
itated
,
ir
r
itab
le/o
v
er
-
r
ea
ctiv
e,
an
d
im
p
atien
ce
;
item
s
1
,
6
,
8
,
1
1
,
1
2
,
1
4
,
1
8
)
.
L
i
k
er
t
s
ca
le
b
etwe
en
0
-
3
f
r
o
m
ev
er
y
q
u
esti
o
n
is
s
u
m
m
ed
,
with
th
e
to
tal
s
co
r
e
o
f
0
-
6
3
.
C
ateg
o
r
izatio
n
is
b
a
s
ed
o
n
p
er
ce
n
tiles
,
wh
er
e
th
e
5
0
th
p
er
ce
n
tile
s
h
o
ws
th
e
av
er
ag
e
m
en
tal
h
ea
lth
s
tatu
s
o
f
th
e
r
esp
o
n
d
er
.
T
h
e
9
0
th
p
e
r
ce
n
tile
an
d
ab
o
v
e
s
h
o
ws
h
ig
h
p
s
y
ch
o
lo
g
i
ca
l
p
r
ess
u
r
e,
r
ef
lectin
g
m
o
r
e
s
y
m
p
to
m
s
co
m
p
a
r
ed
to
p
ee
r
s
o
f
th
e
s
am
e
ag
e.
T
h
e
50
th
p
er
ce
n
tile
,
wh
ic
h
in
d
ica
tes
g
o
o
d
m
en
tal
h
ea
lth
,
is
s
co
r
ed
<3
3
an
d
th
e
9
0
th
p
e
r
c
en
tile
with
>5
2
is
ca
teg
o
r
ized
as lo
w
m
e
n
tal
h
ea
lth
.
An
em
ia
was
as
s
ess
ed
u
s
in
g
a
d
ig
ital
h
em
o
g
lo
b
i
n
m
eter
f
o
r
an
em
ia
f
r
o
m
th
e
b
r
a
n
d
Fam
i
ly
Dr
HB
Me
ter
.
T
h
e
d
ata
wer
e
o
b
tain
ed
f
r
o
m
h
em
o
g
lo
b
in
(
H
b
)
m
ea
s
u
r
em
en
ts
u
s
in
g
b
lo
o
d
s
am
p
les
co
llected
f
r
o
m
s
tu
d
en
ts
’
f
in
g
e
r
tip
s
.
Hb
s
cr
ee
n
in
g
u
s
in
g
a
h
em
o
g
l
o
b
in
o
m
eter
was
c
o
n
s
id
er
ed
ac
c
u
r
ate,
s
h
o
win
g
n
o
s
ig
n
if
ican
t
d
if
f
er
e
n
ce
f
r
o
m
v
en
o
u
s
cy
a
n
m
eth
em
o
g
lo
b
i
n
(
g
o
ld
s
tan
d
a
r
d
)
(
p
=
0
.
6
5
1
)
[
2
4
]
.
T
h
e
d
ig
ital
h
em
o
g
lo
b
in
o
m
eter
s
h
o
wed
a
n
eg
ativ
e
p
r
e
d
ictiv
e
v
alu
e
(
NPV)
o
f
(
7
5
.
8
%),
s
en
s
itiv
ity
(
8
9
.
4
%),
s
p
ec
if
icity
o
f
(
6
3
.
6
%),
an
d
a
p
o
s
itiv
e
p
r
e
d
ic
tiv
e
v
alu
e
(
PP
V)
o
f
(
8
2
.
6
%)
wh
en
co
m
p
ar
ed
with
th
e
au
to
an
aly
ze
r
[
2
5
]
,
w
h
ile
th
e
au
to
m
ated
h
e
m
ato
lo
g
y
a
n
aly
ze
r
with
s
o
d
iu
m
lau
r
y
l
s
u
lp
h
ate
(
AHA
-
SLS)
s
h
o
wed
s
ig
n
if
ican
t
r
esu
lts
(p
:
0
.
0
0
0
)
[
2
6
]
.
T
h
er
ef
o
r
e,
th
e
u
s
e
o
f
a
d
ig
ital
h
em
o
g
lo
b
i
n
o
m
eter
is
co
n
s
id
er
ed
s
u
itab
le
f
o
r
an
em
ia
s
cr
ee
n
in
g
,
esp
ec
ially
at
th
e
c
o
m
m
u
n
ity
lev
el
in
lo
w
-
r
eso
u
r
ce
s
ettin
g
s
.
Acc
o
r
d
i
n
g
t
o
th
e
W
o
r
ld
H
ea
lth
Or
g
an
izatio
n
(
W
HO)
,
an
em
ia
is
in
d
icate
d
b
y
Hb
<1
2
g
/d
L
in
f
em
ales
a
n
d
m
ales
ag
ed
b
etwe
en
1
2
-
4
5
y
ea
r
s
o
ld
[
2
7
]
.
T
h
e
v
ar
iab
le
o
f
n
u
tr
itio
n
al
s
tatu
s
was
m
ea
s
u
r
ed
u
s
in
g
b
o
d
y
m
a
s
s
in
d
ex
(
B
MI
)
,
with
th
e
s
tan
d
ar
d
>
2
5
ca
teg
o
r
ized
as
o
v
er
weig
h
t
an
d
o
b
ese,
an
d
<
1
8
.
5
as
u
n
d
er
weig
h
t.
Mid
-
u
p
p
er
ar
m
cir
cu
m
f
e
r
en
ce
(
MU
AC
)
was
m
ea
s
u
r
ed
u
s
in
g
cu
to
f
f
s
o
f
2
3
cm
f
o
r
f
e
m
ales
an
d
2
3
.
5
cm
f
o
r
m
ales
.
MU
AC
o
f
th
e
d
o
m
in
an
t
ar
m
was
m
ea
s
u
r
ed
at
th
e
m
id
-
p
o
in
t
b
etwe
en
th
e
tip
o
f
t
h
e
s
h
o
u
ld
e
r
an
d
elb
o
w.
Me
as
u
r
em
en
ts
b
elo
w
th
o
s
e
n
u
m
b
er
s
ar
e
co
n
s
id
er
ed
at
r
is
k
o
f
ch
r
o
n
ic
u
n
d
er
n
u
tr
itio
n
[
2
8
]
.
T
h
e
Ko
lm
o
g
o
r
o
v
-
Sm
ir
n
o
v
test
s
h
o
wed
th
at
th
e
d
ata
wer
e
n
o
t
n
o
r
m
ally
d
is
tr
ib
u
ted
(
p
=
0
.
0
0
0
<0
.
0
0
5
)
.
T
h
er
e
f
o
r
e,
Sp
ea
r
m
an
’s
R
h
o
co
r
r
elatio
n
an
aly
s
is
was
u
s
ed
to
ex
am
in
e
th
e
r
elatio
n
s
h
ip
b
etwe
en
m
e
n
tal
h
ea
lth
,
n
u
tr
itio
n
al
s
tatu
s
,
an
d
an
em
ia.
3.
RE
SU
L
T
S AN
D
D
I
SCU
SS
I
O
N
T
h
e
s
u
b
jects o
f
th
is
r
esear
ch
wer
e
1
7
7
f
em
ale
s
tu
d
en
ts
(
6
3
.
9
%)
an
d
1
0
0
m
ale
s
tu
d
en
ts
(
3
6
.
1
%),
with
13
-
y
ea
r
-
o
ld
s
tu
d
en
ts
d
o
m
i
n
atin
g
th
e
s
am
p
le
with
2
0
5
s
tu
d
e
n
ts
(
7
4
%).
B
ased
o
n
t
h
e
B
MI
,
it
was
f
o
u
n
d
th
at
1
3
1
s
tu
d
en
ts
h
ad
n
o
r
m
al
n
u
tr
i
tio
n
al
s
tatu
s
(
4
7
.
3
%),
b
u
t
m
al
n
u
tr
itio
n
was
s
till
o
b
s
er
v
e
d
in
1
0
3
s
tu
d
en
ts
wh
o
wer
e
ca
teg
o
r
ized
as
th
in
(
3
7
.
2
%).
T
h
e
least
n
u
m
b
er
was
o
v
er
weig
h
t
s
tu
d
e
n
ts
,
wh
ich
wer
e
o
b
s
er
v
ed
at
4
3
s
tu
d
en
ts
(
1
5
.
5
%).
L
o
o
k
in
g
at
th
e
m
ea
s
u
r
em
en
t
o
f
a
r
m
,
th
e
a
v
er
ag
e
was
2
1
.
4
8
cm
wh
ich
in
d
icate
d
th
e
r
is
k
o
f
ch
r
o
n
ic
u
n
d
er
n
u
tr
itio
n
.
I
f
b
r
o
k
en
d
o
wn
b
y
s
ex
,
th
en
6
2
(
6
2
.
6
%)
o
f
th
e
m
ale
s
tu
d
en
ts
h
ad
a
MU
AC
<2
3
.
5
cm
,
an
d
1
1
9
f
e
m
ale
s
tu
d
en
ts
(
6
6
.
9
%)
h
ad
a
MU
AC
<2
3
,
s
im
ilar
r
is
k
p
atter
n
s
.
T
h
e
r
esu
lt
o
f
H
b
s
cr
ee
n
in
g
s
h
o
wed
th
at
o
n
a
v
er
ag
e
t
h
e
Hb
was
1
3
.
0
8
g
/d
L
T
h
er
e
wer
e
8
1
s
tu
d
en
ts
(
2
9
.
2
%)
wh
o
h
ad
an
em
ia,
co
n
s
is
tin
g
o
f
6
5
f
em
ale
s
tu
d
en
ts
an
d
1
6
m
ale
s
tu
d
en
ts
.
T
h
e
o
b
s
er
v
atio
n
o
f
m
en
tal
h
ea
lth
co
n
d
itio
n
o
f
th
e
s
tu
d
en
ts
th
r
o
u
g
h
DASS
-
Y
q
u
esti
o
n
n
air
e
s
h
o
w
ed
th
at
in
g
en
er
al
th
e
ju
n
io
r
h
ig
h
s
ch
o
o
l
s
tu
d
en
ts
in
Po
n
ti
an
ak
wer
e
m
e
n
tally
h
ea
lth
y
with
lo
w
r
is
k
o
f
d
e
p
r
ess
io
n
,
an
x
iety
,
an
d
s
tr
ess
in
1
3
5
s
tu
d
en
ts
(
4
8
.
7
%),
m
o
d
er
ate
r
is
k
in
1
1
7
s
tu
d
en
ts
(
4
2
.
2
%)
,
an
d
h
i
g
h
r
is
k
in
2
5
s
tu
d
e
n
ts
(
9
.
0
%).
W
h
e
n
o
b
s
er
v
ed
b
ased
o
n
ea
ch
m
e
n
tal
h
ea
lth
p
r
o
b
lem
,
it
was
f
o
u
n
d
t
h
at
2
8
s
tu
d
e
n
ts
(
1
0
.
1
%)
h
ad
d
e
p
r
ess
io
n
,
2
7
s
tu
d
en
ts
(
9
.
7
%)
h
ad
a
n
x
iety
,
an
d
2
3
s
tu
d
e
n
ts
(
8
.
3
%)
h
ad
s
tr
ess
.
B
ased
o
n
th
e
n
u
m
b
er
o
f
s
tu
d
en
ts
with
an
em
ia
ca
s
es,
it
o
c
cu
r
r
ed
m
o
r
e
o
n
f
e
m
ale
s
tu
d
e
n
ts
th
an
o
n
m
ale
s
tu
d
en
ts
.
T
h
e
r
is
k
o
f
an
em
ia
in
f
em
ale
ad
o
lescen
ts
co
u
ld
b
e
o
b
s
er
v
e
d
f
r
o
m
th
eir
m
en
s
tr
u
atio
n
h
is
to
r
y
.
Of
1
7
7
f
em
ale
s
tu
d
en
ts
,
1
6
1
s
tu
d
en
ts
(
9
0
.
9
6
%)
h
ad
g
o
tten
th
eir
f
ir
s
t
p
er
io
d
.
3
6
f
em
ale
s
tu
d
en
ts
(
2
2
.
3
6
%)
r
ep
o
r
ted
th
e
y
d
id
n
o
t
h
av
e
r
eg
u
lar
p
er
io
d
s
ev
er
y
m
o
n
th
.
Mo
s
t
s
tu
d
en
ts
h
ad
m
en
ar
ch
e
at
th
e
ag
e
o
f
1
1
(
6
2
s
tu
d
en
ts
)
.
T
h
er
e
wer
e
6
5
s
tu
d
en
ts
wh
o
h
ad
m
en
s
tr
u
al
p
e
r
io
d
s
f
o
r
2
y
ea
r
s
,
an
d
9
0
s
tu
d
e
n
ts
m
en
s
tr
u
ated
f
o
r
7
d
ay
s
ev
er
y
m
o
n
th
.
Me
n
s
tr
u
atio
n
th
at
last
s
f
o
r
4
-
7
d
ay
s
wo
u
ld
r
esu
lt
in
3
0
-
8
0
m
l
b
lo
o
d
lo
s
s
p
er
d
ay
,
alo
n
g
with
ir
o
n
,
wh
ic
h
in
t
h
e
lo
n
g
r
u
n
wo
u
l
d
ca
u
s
e
th
e
r
is
k
o
f
ir
o
n
-
d
ef
icie
n
cy
an
e
m
ia
in
f
e
m
a
le
ad
o
lescen
ts
[
2
9
]
.
A
p
r
ev
io
u
s
s
tu
d
y
h
a
d
f
o
u
n
d
a
s
ig
n
if
ican
t
co
r
r
elatio
n
b
etwe
en
m
en
s
tr
u
al
c
y
cle
an
d
an
em
i
a
ca
s
es
[
2
9
]
,
[
3
0
]
.
Mo
s
t
f
em
ale
ad
o
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ts
wh
o
s
u
f
f
er
ed
f
r
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m
a
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ad
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er
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en
o
r
rh
ea
cy
cle
(
>
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d
ay
s
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,
m
ak
in
g
th
em
to
ch
an
g
e
m
e
n
s
tr
u
al
p
ad
s
5
-
6
ti
m
es
p
er
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ay
.
Alth
o
u
g
h
c
o
n
f
li
ctin
g
f
in
d
i
n
g
s
r
eg
ar
d
in
g
th
e
a
s
s
o
ciatio
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b
etwe
en
an
em
ia
an
d
m
en
s
tr
u
atio
n
(
m
e
n
ar
ch
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leed
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g
q
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a
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tity
,
d
u
r
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an
d
r
eg
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lar
ity
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f
cy
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ar
e
s
till
r
ep
o
r
ted
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it
r
em
ain
s
im
p
o
r
tan
t
to
co
n
s
id
er
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ter
v
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n
s
th
at
r
e
d
u
ce
m
e
n
s
tr
u
al
b
lo
o
d
lo
s
s
an
d
th
eir
i
m
p
ac
t
o
n
ir
o
n
lo
s
s
,
esp
ec
ially
in
s
ev
er
e
ca
s
es
[
2
5
]
.
T
h
is
m
en
s
tr
u
al
p
r
o
b
lem
co
u
ld
b
e
ca
u
s
ed
b
y
an
ato
m
ical
p
r
o
b
lem
s
lik
e
u
ter
i
n
e
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B
ased
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ata
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th
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ip
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e
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ia
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tu
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’
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tu
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ia
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ly
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h
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ad
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en
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ea
lth
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e
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ig
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ican
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ip
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h
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icatin
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1
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T
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ip
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DASS
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An
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ased
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ies
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ican
t
co
r
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n
with
m
en
tal
h
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p
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ev
e
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g
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th
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tu
d
y
s
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o
we
d
n
o
s
ig
n
if
ican
t
r
elatio
n
s
h
ip
b
etwe
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th
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two
.
Dep
r
ess
io
n
,
an
x
iety
,
an
d
s
tr
ess
wer
e
ex
p
er
ien
ce
d
b
y
G
en
er
atio
n
-
Z
a
d
o
lescen
ts
wh
o
h
ad
an
em
ia,
with
s
y
m
p
to
m
s
lik
e
n
e
r
v
o
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s
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ess
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ex
ce
s
s
iv
e
an
x
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,
a
n
d
u
n
f
o
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n
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ed
f
ea
r
.
De
p
r
ess
io
n
as
a
r
esp
o
n
s
e
to
m
e
n
tal
h
ea
lth
p
r
o
b
lem
s
was
also
s
u
f
f
er
ed
b
y
ad
o
lescen
ts
with
an
e
m
ia,
lik
e
f
ee
lin
g
s
o
f
h
o
p
eless
n
ess
,
en
th
u
s
iasm
lo
s
s
,
an
d
lo
w
s
elf
-
wo
r
th
,
esp
ec
ially
th
o
s
e
wh
o
wer
e
f
ac
i
n
g
m
ed
ic
al
p
r
o
b
lem
s
[3
2
]
.
L
ac
k
o
f
f
er
r
i
tin
(
th
e
ir
o
n
s
er
u
m
)
an
d
tr
a
n
s
f
er
r
in
i
n
m
ales,
as
with
f
em
ale,
ir
o
n
d
ef
icien
cy
is
p
o
s
itiv
ely
ass
o
ciate
d
with
an
in
cr
ea
s
ed
r
is
k
o
f
d
ep
r
ess
io
n
[3
3
]
,
[
3
4
]
.
T
h
is
co
u
ld
b
e
in
f
lu
en
ce
d
b
y
n
eu
r
o
tr
a
n
s
m
itter
s
y
n
th
esis
an
d
d
is
r
eg
u
latio
n
ab
ilit
y
,
wh
ich
af
f
ec
ts
h
o
r
m
o
n
e
s
u
ch
as d
o
p
a
m
in
e,
s
er
o
to
n
i
n
,
an
d
n
o
r
ep
in
e
p
h
r
in
e
h
o
r
m
o
n
e.
T
h
is
co
u
ld
also
h
ap
p
en
b
ec
a
u
s
e
th
e
ea
r
ly
s
tag
e
o
f
an
em
ia
s
tar
ts
f
r
o
m
th
e
lack
o
f
b
lo
o
d
ce
lls
th
at
b
r
in
g
o
x
y
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en
to
th
e
b
r
ain
a
n
d
th
r
o
u
g
h
o
u
t
th
e
b
o
d
y
,
wh
ich
lead
s
to
s
o
m
e
s
y
m
p
to
m
s
lik
e
f
atig
u
e
an
d
wea
k
n
ess
,
lo
s
in
g
h
a
p
p
in
ess
a
n
d
f
ee
lin
g
s
o
f
s
ad
n
ess
o
f
te
n
o
b
s
er
v
ed
in
d
e
p
r
ess
ed
p
e
o
p
le;
f
u
r
th
er
m
o
r
e,
r
is
k
o
f
an
em
ia
co
u
ld
in
cr
ea
s
e
as
d
ep
r
ess
io
n
s
y
m
p
to
m
s
d
ev
elo
p
[3
5
]
.
E
v
en
tu
ally
,
an
e
m
ia
an
d
m
en
t
al
h
ea
lth
p
r
o
b
lem
s
in
s
tu
d
en
ts
wo
u
ld
in
f
lu
en
ce
t
h
eir
lear
n
in
g
ac
h
iev
e
m
en
t
b
e
ca
u
s
e
o
f
lo
w
co
n
ce
n
tr
atio
n
,
p
h
y
s
ical
p
r
o
b
lem
s
,
r
ed
u
ce
d
ad
ap
ti
v
e
s
k
ill,
a
n
d
d
im
in
is
h
ed
ca
p
a
b
ilit
y
to
co
n
tr
o
l
lear
n
in
g
p
r
ess
u
r
e
[3
6
]
.
Alth
o
u
g
h
o
u
r
f
in
d
i
n
g
s
s
h
o
wed
n
o
ass
o
ciatio
n
b
etwe
en
an
em
ia
an
d
m
en
tal
h
ea
lth
s
tatu
s
,
o
th
er
s
tu
d
ies
r
ep
o
r
t
s
im
ilar
r
esu
lts
,
p
o
s
s
ib
ly
d
u
e
to
co
p
i
n
g
m
ec
h
an
is
m
s
an
d
th
e
1
2
0
-
d
ay
life
s
p
a
n
o
f
r
e
d
b
lo
o
d
ce
lls
,
with
y
o
u
n
g
er
in
d
i
v
id
u
als h
av
in
g
f
aster
p
h
y
s
io
lo
g
ical
r
ec
o
v
er
y
.
I
n
a
d
d
itio
n
,
r
ely
in
g
o
n
ly
o
n
Hb
to
ass
es
s
an
em
ia
m
ay
b
e
in
s
u
f
f
icien
t
to
r
ev
ea
l
p
o
ten
tial
lin
k
s
with
an
x
iety
[3
7
]
.
Mo
r
e
o
v
er
,
s
tr
ess
h
as
b
ee
n
n
eg
ativ
ely
lin
k
e
d
to
Hb
lev
els.
No
r
elatio
n
s
h
ip
s
wer
e
o
b
s
er
v
e
d
b
etwe
en
an
x
iety
an
d
f
er
r
itin
af
ter
ad
ju
s
tin
g
f
o
r
k
ey
v
ar
iab
les
(
b
o
d
y
m
ass
in
d
ex
(
B
MI
)
,
m
en
s
tr
u
atio
n
,
ir
o
n
in
tak
e,
an
d
co
f
f
ee
o
r
tea
co
n
s
u
m
p
tio
n
)
,
an
d
s
er
u
m
ir
o
n
was
u
n
r
elate
d
to
ir
o
n
in
tak
e
b
u
t
d
ec
lin
ed
with
h
ig
h
e
r
B
MI
[3
8
]
.
T
h
ese
r
esu
lts
h
ig
h
lig
h
t
th
e
c
o
m
p
lex
in
ter
p
lay
o
f
p
h
y
s
io
lo
g
ical
an
d
b
eh
av
i
o
r
al
f
ac
to
r
s
in
f
lu
e
n
cin
g
ir
o
n
s
tatu
s
.
E
v
en
th
o
u
g
h
n
o
co
r
r
ela
tio
n
was
f
o
u
n
d
,
o
b
s
er
v
atio
n
an
d
ap
p
r
o
p
r
iate
in
ter
v
en
tio
n
o
n
th
e
s
tu
d
en
ts
with
r
is
k
o
f
m
en
tal
h
ea
lth
n
ee
d
to
b
e
g
iv
en
,
in
clu
d
in
g
p
r
o
v
id
i
n
g
co
u
n
s
elin
g
.
T
h
e
u
s
e
o
f
d
ig
ital
p
latf
o
r
m
s
f
o
r
ch
ild
r
en
’
s
an
d
ad
o
lescen
t
h
ea
lth
s
er
v
ices
co
u
ld
b
e
a
g
o
o
d
b
e
a
b
en
ef
icial
to
o
l
f
o
r
ea
r
ly
p
r
ev
en
tio
n
[
39
]
o
r
b
y
d
o
in
g
p
h
y
s
ical
ac
tiv
ities
,
lik
e
ae
r
o
b
ic
wh
ich
is
b
eliev
e
d
to
lift
m
o
o
d
an
d
co
g
n
itiv
e
f
u
n
ctio
n
w
h
ile
y
o
g
a
an
d
tai
c
h
i c
an
s
u
p
p
o
r
t stre
s
s
m
an
ag
em
e
n
t a
n
d
em
o
tio
n
al
r
e
g
u
latio
n
[4
0
]
.
On
th
e
o
th
er
h
an
d
,
an
o
th
e
r
f
a
cto
r
th
at
ca
u
s
es
an
em
ia
is
ad
o
lescen
ts
’
n
u
tr
itio
n
al
s
tatu
s
.
Fu
r
th
er
m
o
r
e
,
b
ased
o
n
th
e
c
o
r
r
elatio
n
test
b
etwe
en
n
u
tr
itio
n
al
s
tatu
s
an
d
an
em
ia
in
T
ab
le
2
,
it
was
f
o
u
n
d
th
at
4
2
s
tu
d
en
ts
(
5
1
.
9
%)
h
a
d
n
o
r
m
al
n
u
tr
itio
n
a
l
s
tatu
s
,
co
m
p
ar
ed
to
3
1
s
tu
d
e
n
ts
(
3
8
.
3
%)
with
an
em
ia
wh
o
wer
e
u
n
d
er
weig
h
t.
8
1
s
tu
d
en
ts
with
o
u
t
an
em
ia
(
4
5
.
4
%)
h
a
d
n
o
r
m
al
n
u
tr
itio
n
a
l
s
tatu
s
,
f
o
llo
wed
b
y
7
2
s
tu
d
e
n
ts
(
3
6
.
7
%)
h
a
v
in
g
n
u
tr
itio
n
al
s
tatu
s
u
n
d
e
r
weig
h
t
.
B
ased
o
n
Sp
ea
r
m
an
’
s
c
o
r
r
elatio
n
test
,
th
e
p
-
v
alu
e
was
0
.
6
6
4
(
>0
.
0
5
)
,
in
d
icatin
g
n
o
c
o
r
r
elatio
n
b
et
wee
n
n
u
tr
itio
n
al
s
tatu
s
an
d
a
n
em
ia.
T
h
e
co
r
r
elatio
n
co
e
f
f
i
cien
t
was
−0
.
0
2
8
,
s
h
o
win
g
a
n
e
g
ativ
e
an
d
v
er
y
wea
k
r
elatio
n
s
h
ip
.
B
ased
o
n
th
e
s
tu
d
y
th
at
h
ad
b
ee
n
co
n
d
u
cte
d
,
it
was
s
h
o
w
n
th
at
th
e
r
e
was
n
o
co
r
r
elatio
n
b
etwe
en
n
u
tr
itio
n
al
s
tatu
s
an
d
an
em
ia
in
ju
n
io
r
h
ig
h
s
ch
o
o
l
s
tu
d
en
ts
.
T
h
is
r
esu
lt
is
s
im
ilar
to
th
e
p
r
ev
io
u
s
s
tu
d
y
th
at
s
h
o
wed
n
o
co
r
r
elatio
n
b
etwe
e
n
B
MI
an
d
Hb
lev
els
in
ad
o
lescen
t
g
ir
ls
[
1
9
]
,
[
2
1
]
.
Me
n
s
t
r
u
al
b
lo
o
d
lo
s
s
an
d
MU
AC
b
ec
am
e
th
e
m
ain
f
ac
t
o
r
o
f
a
n
em
ia
ca
s
e,
asid
e
o
f
ir
o
n
c
o
n
s
u
m
p
tio
n
[
1
9
]
.
I
r
o
n
co
n
s
u
m
p
tio
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co
u
l
d
b
e
in
f
lu
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ig
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o
n
s
u
m
p
ti
o
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o
f
a
n
tin
u
tr
ien
t
tan
n
in
th
at
ca
n
lo
wer
th
e
a
b
s
o
r
p
tio
n
o
f
ir
o
n
f
r
o
m
f
o
o
d
[4
1
]
.
T
ea
is
o
n
e
o
f
th
e
d
r
in
k
s
th
at
co
n
tain
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in
with
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ce
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tr
atio
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o
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an
d
its
co
n
s
u
m
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id
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ly
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8
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cu
p
/d
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An
o
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f
ac
to
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th
at
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s
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ia
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th
e
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,
l
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ar
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m
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o
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o
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er
als th
at
h
elp
ir
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s
o
r
p
t
io
n
[
1
7
]
.
On
e
o
f
th
e
way
s
to
co
n
tr
o
l
th
e
r
is
k
o
f
an
em
ia
,
wh
ich
in
f
lu
en
ce
s
m
en
tal
h
ea
lth
,
is
b
y
m
o
n
ito
r
in
g
th
e
n
u
tr
itio
n
al
in
tak
e
(
v
ar
iety
o
f
ir
r
eg
u
lar
m
ea
ls
,
an
d
an
im
al
f
o
o
d
s
o
u
r
ce
s
)
,
s
u
p
p
lem
en
t
i
n
tak
e
r
ic
h
in
ir
o
n
,
s
leep
in
g
h
ab
its
,
an
d
f
atig
u
e
[
1
0
]
,
[
1
9
]
,
[
4
3
]
–
[4
5
]
.
E
x
ce
s
s
iv
e
d
ietin
g
in
f
lu
en
ce
d
b
y
ad
o
l
escen
t
b
o
d
y
im
ag
e
to
d
ay
h
as
b
ec
o
m
e
o
n
e
o
f
th
e
r
is
k
f
ac
to
r
s
f
o
r
an
em
ia
[4
6
]
.
Ho
wev
er
,
a
p
r
ev
i
o
u
s
s
tu
d
y
s
h
o
wed
th
at
ir
o
n
in
tak
e
d
id
n
o
t
h
av
e
a
c
o
r
r
elatio
n
with
th
e
Hb
lev
el
an
d
b
o
d
y
im
a
g
e
[4
7
]
.
T
h
is
r
esear
ch
h
as
s
ev
er
al
lim
itatio
n
s
.
T
h
e
cr
o
s
s
-
s
ec
tio
n
al
d
esig
n
r
estricts
ca
u
s
al
in
f
er
en
ce
,
p
ar
ticu
lar
ly
r
eg
ar
d
in
g
th
e
i
n
ter
p
lay
b
etwe
en
ir
o
n
s
tatu
s
an
d
m
en
tal
h
ea
lth
.
T
h
e
r
elian
ce
o
n
Hb
as
th
e
s
o
le
b
io
m
ar
k
e
r
m
ay
o
v
er
lo
o
k
s
u
b
clin
ical
ir
o
n
d
ef
icien
c
y
,
lim
i
tin
g
d
iag
n
o
s
tic
s
en
s
itiv
ity
,
an
d
th
e
ab
s
en
ce
o
f
ad
d
itio
n
al
b
io
c
h
em
ical
in
d
ic
ato
r
s
,
s
u
ch
as
f
er
r
itin
,
C
-
r
e
ac
tiv
e
p
r
o
tein
(
C
R
P),
o
r
tr
a
n
s
f
er
r
in
s
atu
r
atio
n
,
p
r
ev
en
ts
d
if
f
er
e
n
tiatio
n
b
etwe
en
ir
o
n
d
ef
icien
c
y
an
em
ia
an
d
an
em
ia
o
f
in
f
lam
m
atio
n
.
Self
-
r
ep
o
r
ted
d
ietar
y
in
tak
e
an
d
m
en
s
tr
u
al
ch
ar
ac
te
r
is
tics
m
ay
in
tr
o
d
u
ce
r
ec
all
an
d
r
ep
o
r
tin
g
b
ias,
wh
ile
p
s
y
ch
o
s
o
cial
f
ac
to
r
s
th
at
co
u
ld
in
f
l
u
en
ce
m
e
n
tal
h
ea
lth
o
u
tco
m
es we
r
e
n
o
t c
o
m
p
r
eh
en
s
iv
ely
m
ea
s
u
r
ed
.
T
h
e
u
s
e
o
f
q
u
o
ta
s
am
p
lin
g
,
a
lth
o
u
g
h
p
r
ac
tical
f
o
r
s
ch
o
o
l
-
b
ased
r
esear
ch
,
m
ay
in
tr
o
d
u
ce
s
elec
tio
n
b
ias
an
d
lim
it
r
ep
r
esen
tativ
en
ess
,
an
d
s
am
p
lin
g
co
n
f
in
ed
t
o
eig
h
t
h
-
g
r
a
d
e
s
tu
d
e
n
ts
f
u
r
t
h
er
n
ar
r
o
ws
ex
ter
n
al
v
alid
ity
.
Me
asu
r
em
e
n
ts
o
f
MU
AC
an
d
Hb
wer
e
tak
en
at
a
s
in
g
le
tim
e
p
o
i
n
t,
wh
i
ch
m
ay
n
o
t
ca
p
tu
r
e
p
h
y
s
io
lo
g
ical
an
d
d
ietar
y
v
a
r
iatio
n
s
o
v
er
tim
e.
Desp
ite
th
ese
lim
itatio
n
s
,
s
ch
o
o
ls
ca
n
s
tr
en
g
th
en
n
u
tr
itio
n
ed
u
ca
tio
n
,
c
o
n
d
u
ct
r
o
u
tin
e
an
em
ia
s
cr
ee
n
in
g
with
f
o
llo
w
-
u
p
,
en
s
u
r
in
g
co
n
s
is
ten
t
ir
o
n
s
u
p
p
lem
en
tatio
n
.
T
h
ey
ca
n
also
p
r
o
v
id
e
co
u
n
s
elin
g
f
o
r
s
tu
d
en
ts
with
ea
r
ly
m
en
tal
h
ea
lth
s
y
m
p
to
m
s
,
p
r
o
m
o
te
h
ea
lth
y
life
s
ty
le
h
ab
its
,
an
d
in
v
o
l
v
e
p
ar
en
ts
in
m
o
n
ito
r
in
g
ea
tin
g
p
atter
n
s
an
d
o
v
e
r
a
ll
well
-
b
ein
g
.
I
n
ad
d
itio
n
,
it
is
v
er
y
im
p
o
r
tan
t
to
ex
p
lo
r
e
a
n
d
in
c
r
ea
s
e
s
tu
d
en
ts
’
k
n
o
wled
g
e
,
attitu
d
e,
a
n
d
p
r
ac
tice
r
eg
ar
d
in
g
an
em
ia
a
n
d
its
p
r
ev
en
tio
n
T
ab
le
2
.
C
o
r
r
elatio
n
b
etwe
en
n
u
tr
itio
n
al
s
tatu
s
an
d
an
e
m
ia
N
u
t
r
i
t
i
o
n
a
l
s
t
a
t
u
s
N
o
t
a
n
e
mi
a
(
≥
1
2
g
/
d
L)
n
(
%)
A
n
e
m
i
a
(
<
1
2
g
/
d
L)
n
(
%)
To
t
a
l
n
N
o
r
mal
8
9
(
3
2
.
1
)
4
2
(
1
5
.
2
)
1
3
1
O
v
e
r
w
e
i
g
h
t
3
5
(
1
2
.
6
)
8
(
2
.
9
)
43
U
n
d
e
r
w
e
i
g
h
t
7
2
(
2
6
.
0
)
3
1
(
1
1
.
2
)
1
0
3
To
t
a
l
1
9
6
(
7
0
.
8
)
8
1
(
2
9
.
2
)
2
7
7
N
o
t
e
:
S
p
e
a
r
ma
n
’
s
c
o
r
r
e
l
a
t
i
o
n
s
h
o
w
e
d
n
o
s
i
g
n
i
f
i
c
a
n
t
a
ss
o
c
i
a
t
i
o
n
b
e
t
w
e
e
n
n
u
t
r
i
t
i
o
n
a
l
st
a
t
u
s a
n
d
a
n
e
mi
a
,
p
=
.
6
6
4
,
r
ₛ
=
−
.
0
2
8
.
4.
CO
NCLU
SI
O
N
T
h
e
s
tu
d
y
f
o
u
n
d
n
o
s
ig
n
if
ica
n
t
r
elatio
n
s
h
ip
b
etwe
en
an
em
ia,
m
en
tal
h
ea
lth
,
an
d
n
u
tr
iti
o
n
al
s
tatu
s
am
o
n
g
ju
n
i
o
r
h
ig
h
s
ch
o
o
l
s
tu
d
en
ts
in
Po
n
tian
ak
,
with
m
o
s
t
s
tu
d
en
ts
s
h
o
wed
n
o
r
m
al
Hb
lev
els,
g
o
o
d
m
en
tal
well
-
b
ein
g
,
a
n
d
a
d
eq
u
ate
n
u
tr
itio
n
al
s
tatu
s
.
E
v
en
s
o
,
co
n
t
in
u
ed
e
f
f
o
r
ts
a
r
e
n
ee
d
ed
to
s
tr
en
g
th
en
n
u
t
r
itio
n
ed
u
ca
tio
n
,
p
r
o
m
o
te
co
n
s
u
m
p
tio
n
o
f
ir
o
n
-
r
ich
f
o
o
d
s
,
e
n
s
u
r
e
r
eg
u
lar
d
is
tr
ib
u
tio
n
an
d
m
o
n
ito
r
in
g
o
f
ir
o
n
s
u
p
p
lem
en
ts
,
an
d
p
r
o
v
id
e
c
o
u
n
s
elin
g
f
o
r
s
tu
d
en
ts
with
e
ar
ly
s
ig
n
s
o
f
m
en
tal
h
ea
lth
co
n
ce
r
n
s
.
R
o
u
tin
e
m
o
n
ito
r
in
g
o
f
n
u
tr
itio
n
al
s
tatu
s
,
s
u
p
p
o
r
t
f
r
o
m
s
ch
o
o
ls
an
d
p
ar
en
ts
in
d
ev
elo
p
i
n
g
h
ea
lth
y
ea
tin
g
h
a
b
its
,
an
d
co
n
s
is
ten
t m
en
tal
h
ea
lth
p
r
o
g
r
am
s
r
em
ain
ess
en
tial to
m
ain
tain
an
d
im
p
r
o
v
e
s
tu
d
en
ts
’
o
v
e
r
all
h
ea
lth
.
ACK
NO
WL
E
DG
M
E
N
T
S
T
h
e
au
t
h
o
r
s
wo
u
ld
lik
e
to
ex
p
r
ess
th
eir
s
in
ce
r
e
g
r
atitu
d
e
t
o
th
e
Facu
lty
o
f
Me
d
icin
e,
T
an
ju
n
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Un
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ity
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F
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DI
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3
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1
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ated
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3
.
T
h
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f
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a
cc
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ce
with
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Facu
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Un
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m
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ated
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y
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.
AUTHO
R
CO
NT
RI
B
UT
I
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NS ST
A
T
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M
E
N
T
T
h
is
s
tu
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y
was
co
n
d
u
cted
th
r
o
u
g
h
th
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c
o
llab
o
r
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o
f
all
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th
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s
,
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ch
o
f
wh
o
m
m
a
d
e
s
u
b
s
tan
tial
co
n
tr
ib
u
tio
n
s
ac
co
r
d
in
g
to
th
e
C
R
ed
iT
tax
o
n
o
m
y
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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I
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t J Pu
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M
ar
ch
20
26
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78
176
Na
m
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f
Aut
ho
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C
M
So
Va
Fo
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Vi
Su
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Fu
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tin
a
Ar
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a
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ejo
y
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wo
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o
✓
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✓
I
it Fitrian
in
g
r
u
m
✓
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Desr
ian
i L
estar
i
✓
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C
:
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ests
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ip
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l
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k
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ted
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th
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.
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th
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s
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tate
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lict o
f
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est.
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NF
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RM
E
D
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NS
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T
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n
f
o
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ed
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s
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t
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p
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in
th
is
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th
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e
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ll a
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ar
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T
H
I
CAL AP
P
RO
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AL
T
h
is
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ch
was
co
n
d
u
cted
i
n
ac
co
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d
an
ce
with
eth
ical
r
ese
ar
ch
g
u
id
elin
es
an
d
th
e
p
r
in
ci
p
les
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f
th
e
Helsin
k
i
Dec
lar
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n
.
E
th
ical
ap
p
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al
was
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f
r
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m
t
h
e
Facu
lty
o
f
Me
d
icin
e,
T
an
j
u
n
g
p
u
r
a
U
n
iv
er
s
ity
(
Ap
p
r
o
v
al
No
.
4
4
3
7
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2
.
9
/
PG/2
0
2
4
)
.
DATA AV
AI
L
AB
I
L
I
T
Y
T
h
e
d
atasets
g
en
e
r
ated
a
n
d
an
aly
ze
d
d
u
r
in
g
th
e
cu
r
r
en
t
s
tu
d
y
ar
e
n
o
t
p
u
b
licly
av
aila
b
le
d
u
e
to
p
r
iv
ac
y
c
o
n
s
id
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atio
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s
b
u
t a
r
e
av
ailab
le
f
r
o
m
th
e
co
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r
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d
in
g
au
th
o
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p
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n
r
ea
s
o
n
ab
le
r
eq
u
est.
RE
F
E
R
E
NC
E
S
[
1
]
H
.
D
a
n
i
a
l
i
,
M
.
M
a
r
t
i
n
u
sse
n
,
a
n
d
M
.
A
.
F
l
a
t
e
n
,
“
A
g
l
o
b
a
l
me
t
a
-
a
n
a
l
y
si
s
o
f
d
e
p
r
e
ss
i
o
n
,
a
n
x
i
e
t
y
,
a
n
d
s
t
r
e
ss
b
e
f
o
r
e
a
n
d
d
u
r
i
n
g
a
C
O
V
I
D
-
19
,”
H
e
a
l
t
h
Ps
y
c
h
o
l
o
g
y
,
v
o
l
.
4
2
,
n
o
.
2
,
p
p
.
1
2
4
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3
8
,
2
0
2
3
,
d
o
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:
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0
.
1
0
3
7
/
h
e
a
0
0
0
1
2
5
9
.
su
p
p
.
[
2
]
S
.
M
a
h
mu
d
,
M
.
N
a
y
e
m,
a
n
d
D
.
A
b
d
u
l
,
“
T
h
e
g
l
o
b
a
l
p
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v
a
l
e
n
c
e
o
f
d
e
p
r
e
ssi
o
n
,
a
n
x
i
e
t
y
,
st
r
e
ss,
a
n
d
i
n
so
mn
i
a
a
m
o
n
g
g
e
n
e
r
a
l
p
o
p
u
l
a
t
i
o
n
d
u
r
i
n
g
C
O
V
I
D
-
19
p
a
n
d
e
mi
c
:
a
sy
s
t
e
mat
i
c
r
e
v
i
e
w
a
n
d
m
e
t
a
_
a
n
a
l
y
s
i
s,”
T
r
e
n
d
s
i
n
Ps
y
c
h
o
l
o
g
y
,
v
o
l
.
3
1
,
n
o
.
1
,
p
p
.
1
2
5
–
1
5
2
,
2
0
2
3
,
d
o
i
:
1
0
.
1
0
0
7
/
s
4
3
0
7
6
-
0
2
1
-
0
0
1
1
6
-
9.
[
3
]
I
.
M
.
A
l
q
a
h
t
a
n
i
e
t
a
l
.
,
“
P
r
e
v
a
l
e
n
c
e
o
f
d
e
p
r
e
ss
i
o
n
,
a
n
x
i
e
t
y
,
a
n
d
s
t
r
e
ss
a
m
o
n
g
t
h
e
g
e
n
e
r
a
l
p
o
p
u
l
a
t
i
o
n
d
u
r
i
n
g
C
O
V
I
D
-
19
p
a
n
d
e
mi
c
:
a
sy
st
e
mat
i
c
r
e
v
i
e
w
,
”
J
o
u
r
n
a
l
o
f
F
a
m
i
l
y
Me
d
i
c
i
n
e
a
n
d
Pr
i
m
a
r
y
C
a
r
e
,
v
o
l
.
1
2
,
p
p
.
1
0
3
0
–
1
0
3
7
,
2
0
2
3
,
d
o
i
:
1
0
.
4
1
0
3
/
j
f
mp
c
.
j
f
m
p
c
.
[
4
]
Y
.
Ji
a
n
g
,
W
.
D
e
n
g
,
a
n
d
M
.
Z
h
a
o
,
“
I
n
f
l
u
e
n
c
e
o
f
t
h
e
C
O
V
I
D
-
1
9
p
a
n
d
e
mi
c
o
n
t
h
e
p
r
e
v
a
l
e
n
c
e
o
f
d
e
p
r
e
ssi
o
n
i
n
U
.
S.
a
d
u
l
t
s
:
e
v
i
d
e
n
c
e
f
r
o
m
N
H
A
N
ES
,”
S
c
i
e
n
t
i
f
i
c
Re
p
o
rt
s
,
v
o
l
.
1
5
,
n
o
.
3
1
0
7
,
p
p
.
1
–
1
0
,
2
0
2
5
,
d
o
i
:
1
0
.
1
0
3
8
/
s
4
1
5
9
8
-
0
2
5
-
8
7
5
9
3
-
5.
[
5
]
J.
B
u
r
k
a
u
s
k
a
s
,
I
.
B
r
a
n
c
h
i
,
S
.
P
a
l
l
a
n
t
i
,
a
n
d
K
.
D
o
ms
c
h
k
e
,
“
A
n
x
i
e
t
y
i
n
p
o
st
-
C
O
V
I
D
-
19
sy
n
d
r
o
m
e
–
p
r
e
v
a
l
e
n
c
e
,
mec
h
a
n
i
sms
a
n
d
t
r
e
a
t
me
n
t
,
”
N
e
u
r
o
sc
i
e
n
c
e
A
p
p
l
i
e
d
,
v
o
l
.
3
,
n
o
.
2
0
2
4
,
p
.
1
0
3
9
3
2
,
2
0
2
4
,
d
o
i
:
1
0
.
1
0
1
6
/
j
.
n
sa
.
2
0
2
3
.
1
0
3
9
3
2
.
[
6
]
W
.
W
.
Y
.
Ta
y
,
J.
Jes
u
t
h
a
sa
n
,
K
.
S
.
W
a
n
,
T.
O
n
g
,
a
n
d
F
.
M
u
s
t
a
p
h
a
,
“
Ei
g
h
t
e
e
n
mo
n
t
h
s
i
n
t
o
t
h
e
C
O
V
I
D
-
1
9
p
a
n
d
e
m
i
c
:
t
h
e
p
r
e
v
a
l
e
n
c
e
o
f
d
e
p
r
e
ssi
o
n
,
a
n
x
i
e
t
y
,
a
n
d
st
r
e
ss
sy
m
p
t
o
ms
i
n
S
o
u
t
h
e
a
st
A
s
i
a
a
n
d
t
h
e
a
sso
c
i
a
t
e
d
d
e
m
o
g
r
a
p
h
i
c
f
a
c
t
o
r
s,”
Fr
o
n
t
P
u
b
l
i
c
H
e
a
l
t
h
,
v
o
l
.
1
0
:
8
6
3
3
2
3
.
,
2
0
2
2
,
d
o
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:
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0
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3
3
8
9
/
f
p
u
b
h
.
2
0
2
2
.
8
6
3
3
2
3
.
[
7
]
C
e
n
t
e
r
f
o
r
R
e
p
r
o
d
u
c
t
i
v
e
H
e
a
l
t
h
,
U
n
i
v
e
r
si
t
y
o
f
Q
u
e
e
n
sl
a
n
d
,
&
J
o
h
n
s
H
o
p
k
i
n
s
B
l
o
o
mb
e
r
g
S
c
h
o
o
l
o
f
P
u
b
l
i
c
H
e
a
l
t
h
.
I
n
d
o
n
e
si
a
–
N
a
t
i
o
n
a
l
A
d
o
l
e
sc
e
n
t
M
e
n
t
a
l
H
e
a
l
t
h
S
u
r
v
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(
I
-
N
A
M
H
S
)
R
e
p
o
r
t
.
C
e
n
t
e
r
f
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p
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o
d
u
c
t
i
v
e
H
e
a
l
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h
,
2
0
2
2
.
[
8
]
F
.
F
e
k
i
h
-
R
o
m
d
h
a
n
e
a
n
d
H
.
A
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tan
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c
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id
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sr
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S
h
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c
a
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o
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tac
ted
a
t
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m
a
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:
d
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sria
n
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les
tari@m
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d
ica
l.
u
n
tan
.
a
c
.
i
d
.
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